1
HESI RN EXIT EXAM V2 2025/2026, VERIFIED REAL
EXAM QUESTIONS, GRADED A+, NGN FORMAT, PASS
GUARANTEE
Question 1
A 65-year-old male client with chronic heart failure is admitted due to worsening shortness of
breath and orthopnea. On assessment, the nurse notes crackles in the bilateral lower lobes and 3+
pitting edema in the lower extremities. Which prescription should the nurse question?
A. Administer furosemide 40 mg IV push once
B. Encourage oral fluid intake of 3 L per day
C. Place the client in high Fowler’s position
D. Monitor intake and output closely
Correct Answer: B. Encourage oral fluid intake of 3 L per day
Rationale: In a client with heart failure, excessive fluid intake can worsen fluid overload. Fluid
restriction, not encouragement, is generally recommended. The other interventions support
oxygenation and fluid balance.
Question 2
A postpartum client who delivered via cesarean section 2 days ago reports calf pain, warmth, and
swelling. The nurse suspects a deep vein thrombosis (DVT). What is the priority nursing
intervention?
A. Apply a warm compress to the calf
B. Massage the calf gently
, 2
C. Maintain the client on bed rest with the affected leg elevated
D. Encourage ambulation to prevent further clots
Correct Answer: C. Maintain the client on bed rest with the affected leg elevated
Rationale: Elevating the affected extremity promotes venous return and reduces swelling.
Massaging or ambulating can dislodge the clot, increasing the risk for pulmonary embolism.
Warm compresses may be used later, but not as a priority.
Question 3
A nurse is preparing to administer metoprolol to a client with hypertension. The client's blood
pressure is 110/70 mmHg and heart rate is 52 bpm. What is the appropriate action?
A. Hold the medication and notify the provider
B. Administer the medication and monitor the client
C. Give half the dose and reassess in 2 hours
D. Encourage oral fluids before giving the dose
Correct Answer: A. Hold the medication and notify the provider
Rationale: Metoprolol, a beta-blocker, can lower heart rate. A heart rate of 52 bpm is
bradycardic. The nurse should hold the medication and notify the provider to prevent further
bradycardia.
Question 4
A client with COPD is receiving oxygen via nasal cannula at 4 L/min. He becomes increasingly
lethargic and confused. What is the nurse’s best response?
A. Increase the oxygen to 6 L/min
B. Encourage the client to cough and deep breathe
C. Lower the oxygen flow to 2 L/min and notify the provider
D. Place the client in a supine position
Correct Answer: C. Lower the oxygen flow to 2 L/min and notify the provider
Rationale: In COPD, high oxygen flow can suppress the hypoxic drive, leading to CO₂
, 3
retention. Oxygen therapy should be closely titrated, often kept below 3 L/min unless otherwise
prescribed.
Question 5
During assessment of a client in a manic state, which finding requires immediate attention?
A. Grandiose thoughts and pressured speech
B. Constant pacing and impulsive behaviors
C. Not eating meals for 12 hours
D. Throwing objects at staff when redirected
Correct Answer: D. Throwing objects at staff when redirected
Rationale: Safety is the priority. Aggressive behavior places both the client and others at risk.
While other symptoms are concerning, physical aggression requires immediate intervention.
Question 6
A client on a heparin drip has an aPTT of 120 seconds (normal: 30–40 seconds). What is the
nurse’s first action?
A. Stop the infusion and notify the provider
B. Continue the infusion and recheck levels in 2 hours
C. Administer protamine sulfate immediately
D. Increase the infusion rate to reach therapeutic level
Correct Answer: A. Stop the infusion and notify the provider
Rationale: A dangerously high aPTT increases the risk for bleeding. The nurse must stop the
infusion and notify the provider. Protamine sulfate may be given depending on the severity.
Question 7
A client with newly diagnosed type 1 diabetes is learning about insulin injections. Which
statement by the client indicates a need for further teaching?
A. "I will rotate injection sites to prevent lipodystrophy."
, 4
B. "I will check my blood sugar before each meal."
C. "I will inject insulin into my thigh before running."
D. "I will store my unopened insulin in the refrigerator."
Correct Answer: C. "I will inject insulin into my thigh before running."
Rationale: Exercise increases insulin absorption. Injecting into a limb about to be exercised may
cause hypoglycemia. Abdomen is the preferred site for consistent absorption.
Question 8
Which lab result would the nurse expect in a client experiencing diabetic ketoacidosis (DKA)?
A. Blood glucose 80 mg/dL
B. Serum bicarbonate 24 mEq/L
C. pH 7.32
D. Positive serum ketones
Correct Answer: D. Positive serum ketones
Rationale: DKA is characterized by hyperglycemia, metabolic acidosis (low pH, low
bicarbonate), and ketonemia. Positive serum ketones confirm fat breakdown due to insulin
deficiency.
Question 9
A client with schizophrenia says, “The government implanted a chip in my brain.” What is the
best nursing response?
A. “There is no chip implanted in your brain.”
B. “Why do you think that happened?”
C. “That must be very frightening for you.”
D. “You need to stop talking about things that aren’t real.”
Correct Answer: C. “That must be very frightening for you.”
Rationale: Acknowledging the client’s feelings builds trust. Challenging the delusion directly is
non-therapeutic. Empathy without reinforcing the delusion is the appropriate approach.
HESI RN EXIT EXAM V2 2025/2026, VERIFIED REAL
EXAM QUESTIONS, GRADED A+, NGN FORMAT, PASS
GUARANTEE
Question 1
A 65-year-old male client with chronic heart failure is admitted due to worsening shortness of
breath and orthopnea. On assessment, the nurse notes crackles in the bilateral lower lobes and 3+
pitting edema in the lower extremities. Which prescription should the nurse question?
A. Administer furosemide 40 mg IV push once
B. Encourage oral fluid intake of 3 L per day
C. Place the client in high Fowler’s position
D. Monitor intake and output closely
Correct Answer: B. Encourage oral fluid intake of 3 L per day
Rationale: In a client with heart failure, excessive fluid intake can worsen fluid overload. Fluid
restriction, not encouragement, is generally recommended. The other interventions support
oxygenation and fluid balance.
Question 2
A postpartum client who delivered via cesarean section 2 days ago reports calf pain, warmth, and
swelling. The nurse suspects a deep vein thrombosis (DVT). What is the priority nursing
intervention?
A. Apply a warm compress to the calf
B. Massage the calf gently
, 2
C. Maintain the client on bed rest with the affected leg elevated
D. Encourage ambulation to prevent further clots
Correct Answer: C. Maintain the client on bed rest with the affected leg elevated
Rationale: Elevating the affected extremity promotes venous return and reduces swelling.
Massaging or ambulating can dislodge the clot, increasing the risk for pulmonary embolism.
Warm compresses may be used later, but not as a priority.
Question 3
A nurse is preparing to administer metoprolol to a client with hypertension. The client's blood
pressure is 110/70 mmHg and heart rate is 52 bpm. What is the appropriate action?
A. Hold the medication and notify the provider
B. Administer the medication and monitor the client
C. Give half the dose and reassess in 2 hours
D. Encourage oral fluids before giving the dose
Correct Answer: A. Hold the medication and notify the provider
Rationale: Metoprolol, a beta-blocker, can lower heart rate. A heart rate of 52 bpm is
bradycardic. The nurse should hold the medication and notify the provider to prevent further
bradycardia.
Question 4
A client with COPD is receiving oxygen via nasal cannula at 4 L/min. He becomes increasingly
lethargic and confused. What is the nurse’s best response?
A. Increase the oxygen to 6 L/min
B. Encourage the client to cough and deep breathe
C. Lower the oxygen flow to 2 L/min and notify the provider
D. Place the client in a supine position
Correct Answer: C. Lower the oxygen flow to 2 L/min and notify the provider
Rationale: In COPD, high oxygen flow can suppress the hypoxic drive, leading to CO₂
, 3
retention. Oxygen therapy should be closely titrated, often kept below 3 L/min unless otherwise
prescribed.
Question 5
During assessment of a client in a manic state, which finding requires immediate attention?
A. Grandiose thoughts and pressured speech
B. Constant pacing and impulsive behaviors
C. Not eating meals for 12 hours
D. Throwing objects at staff when redirected
Correct Answer: D. Throwing objects at staff when redirected
Rationale: Safety is the priority. Aggressive behavior places both the client and others at risk.
While other symptoms are concerning, physical aggression requires immediate intervention.
Question 6
A client on a heparin drip has an aPTT of 120 seconds (normal: 30–40 seconds). What is the
nurse’s first action?
A. Stop the infusion and notify the provider
B. Continue the infusion and recheck levels in 2 hours
C. Administer protamine sulfate immediately
D. Increase the infusion rate to reach therapeutic level
Correct Answer: A. Stop the infusion and notify the provider
Rationale: A dangerously high aPTT increases the risk for bleeding. The nurse must stop the
infusion and notify the provider. Protamine sulfate may be given depending on the severity.
Question 7
A client with newly diagnosed type 1 diabetes is learning about insulin injections. Which
statement by the client indicates a need for further teaching?
A. "I will rotate injection sites to prevent lipodystrophy."
, 4
B. "I will check my blood sugar before each meal."
C. "I will inject insulin into my thigh before running."
D. "I will store my unopened insulin in the refrigerator."
Correct Answer: C. "I will inject insulin into my thigh before running."
Rationale: Exercise increases insulin absorption. Injecting into a limb about to be exercised may
cause hypoglycemia. Abdomen is the preferred site for consistent absorption.
Question 8
Which lab result would the nurse expect in a client experiencing diabetic ketoacidosis (DKA)?
A. Blood glucose 80 mg/dL
B. Serum bicarbonate 24 mEq/L
C. pH 7.32
D. Positive serum ketones
Correct Answer: D. Positive serum ketones
Rationale: DKA is characterized by hyperglycemia, metabolic acidosis (low pH, low
bicarbonate), and ketonemia. Positive serum ketones confirm fat breakdown due to insulin
deficiency.
Question 9
A client with schizophrenia says, “The government implanted a chip in my brain.” What is the
best nursing response?
A. “There is no chip implanted in your brain.”
B. “Why do you think that happened?”
C. “That must be very frightening for you.”
D. “You need to stop talking about things that aren’t real.”
Correct Answer: C. “That must be very frightening for you.”
Rationale: Acknowledging the client’s feelings builds trust. Challenging the delusion directly is
non-therapeutic. Empathy without reinforcing the delusion is the appropriate approach.
